3428075_24_Sanitized Scrubbed Guide Presentation

Company Name • 2024-2025 Benefits Guide

WHO IS ELIGIBLE? Benefits are available to all full-time Employees working a minimum of 30 hours per week and eligible dependents. For those enrolling during Open Enrollment, your benefits will become effective on April 1st, 2024. For new hires, your benefits will become effective on the first of the month following 30 days from your date of hire.

MAKING CHANGES You may only make changes to your elections during open enrollment each year or during the year if you experience a qualifying event. Qualifying events include, but are not limited to: z Birth, legal adoption, or placement for adoption. z Marital status. z Dependent child reaches age 26. z Spouse gains or loses employment or eligibility with current employer. z Death of a covered dependent. z Spouse or dependent becomes eligible or ineligible for Medicare/Medicaid or SCHIP. z Change in residence that changes eligibility for coverage. z Court-ordered change. Changes to your coverage due to a qualifying life event must be made within 30 days of that life event. Proof of the qualifying life event is required (marriage certificate, divorce decree, birth certificate, or loss of coverage letter). You can submit a Qualifying Life Event directly in UKG under the Life Events tab.

Eligible dependents include:

Your legal spouse or domestic partner

Your children from birth to age 26

(Including your natural/legally adopted/stepchildren, and/ or your unmarried dependent children of any age who are mentally or physically disabled and who are dependent on you for support) HOW TO ENROLL To sign up for benefits, visit https:xyz.com before the end of your enrollment period.

Note: Any change you make to your coverage must be consistent with the change in status.

ENROLLMENT DEADLINES

Type of Employee/Dependent

Enrollment opportunity

Coverage effective date

Current Employee

Annually during the enrollment period

Start of plan year

First of the month following 30 days from your date of hire.

New hire

Must enroll within 30 days of hire

Changes must be made within 30 days of life event

Qualified life event

Date of life event

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